Adult scoliosis is a scoliosis deformity found after epiphyseal maturation, generally considered to be after the age of 20 years, in which the patient has a spinal deformity with a Cobb angle greater than 10 degrees in the coronal plane of the spine. There are two types of adult scoliosis: one is a deformity that occurs before skeletal maturity. The deformity persists thereafter. And may be aggravated after the age of 20 years; there is also a class in the skeletal maturity of Cobb angle greater than 10 degrees of spinal deformity, which is mostly secondary to degenerative diseases, osteoporosis or osteochondrosis, the deformity is mainly located in the lumbar vertebrae, and most often in the elderly over the age of 50 years. The prevalence of scoliosis in adults ranges from 1.4% to 12%, and is increasing with the aging of the population. Unlike adolescent scoliosis, adult scoliosis tends to be more rigid than adolescent scoliosis, and is often associated with spinal stenosis and radicular symptoms, as well as other systemic diseases such as hypertension, coronary heart disease, and diabetes mellitus, etc. Therefore, surgical treatment of adult scoliosis has traditionally been a major concern in the scoliosis community, and the risks and possibilities of complications are much greater than those of adolescent scoliosis. In adult scoliosis, the main goals of surgery are to achieve spinal balance, pain relief, and strong fusion, while the improvement in appearance brought about by correction of the deformity can also alleviate the psychosocial abnormalities of the patients. Elderly patients with degenerative scoliosis are characterized by: 1. Deformities are mostly located in the lumbar and thoracolumbar segments; 2. In addition to rigid coronal deformities, severe sagittal imbalances, such as flat back syndrome, are often present, and sometimes the sagittal deformity is the main cause of the symptoms; 3. There are usually a variety of other degenerative problems in combination with the deformities, such as spinal stenosis, herniated discs, and osteoporosis, which result in significant low back pain and nerve and spinal cord compression symptoms. This leads to significant low back pain and nerve and spinal cord compression, and is the main reason for patients to seek medical attention. In adult scoliosis, if there is only a curvature and the degree is not serious, it is possible to observe and do some exercises, etc.; if the curvature is accompanied by low back pain or even lower limb pain and numbness, it is necessary to take surgical treatment methods as soon as possible. Adult scoliosis is the hot spot and difficult point of research in the field of scoliosis at home and abroad. Surgical treatment mainly includes anterior release, interbody fusion, reconstruction of the physiological curvature of the spine, combined with posterior decompression, pedicle screw technique and so on. Selective segmental fixation is used to treat moderate scoliosis; posterior segmental fixation is used for severe scoliosis from 70° to 90°, instead of anterior release combined with posterior hybrid fixation. Surgical indications Adult scoliosis requires surgical treatment for only 20%-25%, the indications for surgery are mainly pain, deformity progression, dysfunction and the psychological impact of deformity on the patient. Pain: Adult scoliosis patients often complain of low back pain, the incidence of which is 60% to 80%, and low back pain is serious and persistent. Pain is a common clinical manifestation of adult scoliosis and the most common indication for surgery, accounting for about 85%-90% of patients undergoing surgery. 2. Deformity progression: Deformity progression is the most widely accepted indication for surgery. It is now recognized that idiopathic scoliosis continues to progress into adulthood. The reasons for progression are not well understood, but there may be no obvious relationship to pregnancy and certain hormonal factors. Degenerative scoliosis in the elderly is another type of scoliosis that can continue to progress in exactly the same way as idiopathic scoliosis. If scoliosis continues to progress and the deformity is severe (Cobb angle greater than 50 degrees) or accompanied by coronal or sagittal decompensation, surgical treatment is required. 3. Pulmonary dysfunction: appears in severe thoracic scoliosis, especially with thoracic lordosis. In addition, the psychological impact of chronic pain and spinal deformity on patients should also be seriously considered. Due to the appearance of deformity and dysfunction, it is often difficult for patients to be accepted by the society, and they are affected in many aspects such as work, life and marriage, which brings them a heavy psychological burden. The deformity correction rate of adult scoliosis ranges from 37% to 51%, but how much deformity is corrected is not the main goal, the important thing is to obtain a strong and balanced spine, which can relieve the symptoms and improve the function. Complications of Surgery Complications of surgery in adults tend to be more numerous and severe than in adolescents with scoliosis. These include postoperative nail channel pain, pseudoarthrosis, imbalance, infection and pulmonary complications. However, with the improvement of surgical techniques, anesthesia techniques, perioperative management and other comprehensive levels, more and more adult scoliosis patients are undergoing surgeries to relieve pain, regain uprightness, improve quality of life and regain confidence.